Infliximab and
golimumab are intravenously (IV) administered
tumor necrosis factor inhibitors approved to treat moderate-to-severe
rheumatoid arthritis (RA) with concomitant
methotrexate. Owing to differences in biologic construct, patients with IV-
infliximab treatment failure may benefit from switching to IV-
golimumab. Utilizing the ACR's Rheumatology Informatics System for Effectiveness (RISE), a large electronic health records registry based in the USA, we assessed RA disease activity in patients switching from IV-
infliximab to IV-
golimumab. This retrospective, longitudinal, single-arm study included adults (≥ 18 years) with ≥ 1 RA diagnosis code between 2014 and 2018 and ≥ 1 IV-
infliximab prescription within 6 months of a new IV-
golimumab order (index date). Longitudinal assessments of disease activity using the Clinical Disease Activity Index (CDAI) were calculated in patients continuing IV-
golimumab for 6-9- and 9-12-months post-switch. Paired t-tests evaluated significance of mean improvements during the follow-up periods. Most RA patients with disease activity assessments during the 6-month follow-up (N = 100; mean age: 65.3 years; 81% female; 74% white) demonstrated moderate-to-high disease activity (CDAI: 73% [38/52]) at enrollment. On average, patients showed significant improvement in disease activity within 6-9 months of switching; mean CDAI scores improved from 21.3 to 14.1 (p < 0.0001) and were durable through 9-12 months of treatment. Real-world patients with moderate-to-high disease activity who switched from IV-
infliximab to IV-
golimumab demonstrated significant and sustained improvements post-switch as measured by the CDAI. Key Points • This study used real-world data from the Rheumatology Informatics System for Effectiveness (RISE) registry to evaluate the efficacy of directly switching from intravenous (IV)-
infliximab to IV-
golimumab to control
rheumatoid arthritis (RA) disease activity. • Most IV-
infliximab patients had moderate-to-high disease activity at the time of the switch. • On average, IV-
golimumab was effective in improving RA disease activity after switching from IV-
infliximab as measured by the Clinical Disease Activity Index. • These data suggest that real-world RA patients with persistent symptoms despite treatment with IV-
infliximab may realize improved disease control with a switch to IV-
golimumab.